James Larkin
With the widespread use of drugs like pembrolizumab and the combination of ipilimumab and nivolumab to treat advanced melanoma in the UK, there is increasing interest in trying to understand why these treatments are not always effective and to develop other treatments that can potentially work if these treatments are not successful.

Pembrolizumab and nivolumab target PD-1 whilst ipilimumab targets CTLA4. There are a number of other similar targets on the surface of immune cells and already drugs have been developed and are undergoing testing in early clinical trials to investigate safety and activity, particularly when immunotherapy treatments have not been successful. Examples of these targets include LAG3 and TIM3.

These trials are in the very early stages and as such involve frequent visits to hospital, the risk of side effects and like almost all clinical trials require a high level of general fitness (performance status) for eligibility.

New targets were one of the themes of the recent Society for Melanoma Research meeting which was held in November 2016 in Boston, Massachusetts. The meeting was held over 4 days and had 11 different sessions ranging from the basic science of melanoma to results from clinical trials, taking in along the way for example sessions discussing careers for men and women in science and medicine.

Notably, there was a specific session on uveal (eye) melanomas, highlighting advances in the understanding of this disease from a scientific perspective.

Despite advances in the treatment of cutaneous (skin) and mucosal melanomas in the last few years, there has been little progress in the treatment of advanced uveal melanoma in the clinic. This therefore remains a disease in which there is no treatment that is generally effective and as such emphasises the importance of continuing to carry out clinical trials to try and improve outcomes for patients.